Post-Malaria Anemia Is Rare in Malawian Children with Cerebral Malaria. 2021

Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
1Department of Pediatrics, Children's National Medical Center, Washington, District of Columbia.

Artesunate therapy for severe malaria syndromes has been associated with post-treatment hemolysis and anemia. We defined post-malaria anemia as any decrease in hematocrit between the index hospitalization for severe malaria and 1 month after. We determined the incidence and severity of post-malaria anemia in Malawian children surviving cerebral malaria (CM) by analyzing hospital and follow-up data from a long-standing study of CM pathogenesis. Children enrolled before 2014 and treated with quinine (N = 258) were compared with those admitted in 2014 and after, and treated with artesunate (N = 235). The last hematocrit value obtained during hospitalization was compared with the 1-month post-hospitalization hematocrit value. The overall rate of a post-hospitalization decrease in hematocrit in children surviving CM was 5.3% (11 of 235 or 4.7% for quinine, 15 of 258 or 5.8% for artesunate; odds ratio, 3.23 [0.88, 18.38]); no patients with a decrease in hematocrit were symptomatic, and none required transfusion after hospitalization. Of the 26 children who had a decrease in hematocrit 1 month after hospitalization, 23.1% had evidence of a new malaria infection. When children treated with quinine and artesunate were combined, a higher hematocrit level on admission, lower quantitative histidine-rich protein level, and splenomegaly were associated independently with post-malaria anemia. In African survivors of CM, post-malaria anemia is rare, mild, and unassociated with the anti-malarial treatment received.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008295 Malawi A republic in southern Africa east of ZAMBIA and MOZAMBIQUE. Its capital is Lilongwe. It was formerly called Nyasaland. Nyasaland,Republic of Malawi
D008297 Male Males
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000740 Anemia A reduction in the number of circulating ERYTHROCYTES or in the quantity of HEMOGLOBIN. Anemias

Related Publications

Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
April 2017, Clinical and vaccine immunology : CVI,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
June 1993, Ophthalmology,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
March 2011, Tropical medicine & international health : TM & IH,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
April 1999, Annals of tropical medicine and parasitology,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
March 1993, Lancet (London, England),
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
May 2011, The American journal of pathology,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
November 2018, Malaria journal,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
January 2001, The American journal of tropical medicine and hygiene,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
February 2016, mBio,
Geoffrey Guenther, and Alexuse M Saidi, and Rima Izem, and Karl Seydel, and Douglas G Postels
January 2019, Journal of blood medicine,
Copied contents to your clipboard!